Antibiotic resistance of Helicobacter pylori and related risk factors in Hunan Province: A multicenter study

BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori (H. pylori ) infection. The antibiotic resistance spectrum of H. pylori varies in different regions. We investigated the current status of antibiotic resistance of H. pylori in Hunan Province and analyzed the factors related to such resistance to provide strategies for the accurate clinical treatment of H. pylori infection. AIM To understand the antibiotic resistance of H. pylori in Hunan Province and provide guidance for the clinical treatment of H. pylori infection. METHODS This study selected patients who underwent gastroscopy in five hospitals in Hunan Province from April 2022 to April 2023. The sensitivity of H. pylori to clarithromycin, levofloxacin, metronidazole, amoxicillin, furazolidone, and tetracycline was detected using the Agar dilution method. RESULTS H. pylori strains from a total of 566 patients were isolated and identified. The resistance rates of H. pylori strains to clarithromycin, levofloxacin, metronidazole, amoxicillin, furazolidone, and tetracycline were 49.2%, 37.8%, 76.1%, 2.3%, 1.4%, and 0.7%, respectively. The resistance rates to clarithromycin, levofloxacin, and metronidazole were high in the four regions of Hunan Province, and the overall resistance rates in central Hunan Province were higher than those in other regions. The resistance rates of H. pylori strains to clarithromycin and levofloxacin were significantly different among the different age groups (P < 0.05), with the elderly group having a higher resistance rate than the young group. The resistance rate of H. pylori strains to clarithromycin was greater in patients with atrophic gastritis, and the resistance rate to levofloxacin was the lowest in patients with peptic ulcers. CONCLUSION The resistance rate of H. pylori to amoxicillin, clarithromycin, and metronidazole is high in Hunan Province. Age, stomach disease, and H. pylori reinfection may affect the antibiotic resistance of H. pylori .